Organization Active NPI

Larusso DC PA of Wellington

  • Chiropractor
  • Wellington, FL
National Provider Identifier
1750368593
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0003139 Issued in FL
Legal business name
LARUSSO DC PA OF WELLINGTON
Practice address
13860 Wellington Trce
Suite # 13
Wellington, FL 33414-8588
Phone
(561) 793-4700
Fax
(561) 793-5504
NPI assigned
Dec 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Salvatore D Larusso, DC
Title
President
Phone
(561) 793-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0003139 FL Primary

Addresses

Primary practice location

13860 Wellington Trce
Suite # 13
Wellington, FL 33414-8588

Mailing address

13860 Wellington Trce
Suite # 13
Wellington, FL 33414-8588
Phone (561) 793-4700

Other identifiers 3

IdentifierTypeStateIssuer
88377AOtherFLBLUE CROSS BLUE SHIELD
382188900MedicaidFL
350055830OtherFLRAILROAD MEDICARE

Other names 1

  • Family Chiropractic Center of Wellington Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080517000013 FL Part B Supplier - Clinic/Group Practice 5597834549 Receives reassigned benefits from 1 practitioner
Practice locations: Wellington, FL

National Provider Directory

National Provider Directory

Locations

13860 Wellington Trce
Ste 13
Wellington, FL 33414
Phone (561) 793-4700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1750368593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13860 WELLINGTON TRCE",
            "address_2": "SUITE # 13",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148588",
            "telephone_number": "561-793-4700",
            "fax_number": "561-793-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13860 WELLINGTON TRCE",
            "address_2": "SUITE # 13",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148588",
            "telephone_number": "561-793-4700",
            "fax_number": "561-793-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARUSSO DC PA OF WELLINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "LARUSSO",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-793-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0003139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88377A",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382188900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350055830",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Chiropractic Center of Wellington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.